Provider Demographics
NPI:1891253167
Name:PERRY, JESSICA A (OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:PERRY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 HOLLY CIR
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-3818
Mailing Address - Country:US
Mailing Address - Phone:401-595-6128
Mailing Address - Fax:
Practice Address - Street 1:863 HATHAWAY RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1916
Practice Address - Country:US
Practice Address - Phone:508-996-6763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8683225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist